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Ultrasound-Guided Internal Radiotherapy Using Yttrium-90-Glass Microspheres for Liver Malignancies

Departments of Nuclear Medicine and Ultrasound, The Great Wall Hospital, Beijing, China

Correspondence: For correspondence or reprints contact: Jia-He Tian, MD, Department of Nuclear Medicine, The Great Wall Hospital, Beijing, China 100853.

ABSTRACT

Treatment of liver malignancies, in particular hepatocellular carcinoma, remains a serious problem because of the difficulty of delivering adequate therapeutic agents to the lesions while sparing the surrounding normal tissue. In an attempt to overcome this obstacle, intratumoral injection of ⁹⁰Y, a beta-emitter, was performed. Methods: Twenty-seven hepatocellular carcinoma's and six liver metastases were studied, most of which had failed other therapeutic modalities. Guided by ultrasound, ⁹⁰Y-glass microspheres (GMS) were carefully injected into predetermined tumor sites. The procedure was repeated at 3–4-wk intervals where indicated. Echographic, clinical and laboratory follow-up was conducted at regular intervals. Results: Twelve to 32 mo after treatment, 27 patients were still alive, with dramatic improvement of their clinical condition: 90.6% of the tumor foci became smaller, with echogenic or blood flow changes on liver sonograms. Serum titers of alpha-FP in 10 of 13 patients returned to normal levels. Repeat biopsy in nine patients showed complete tumor destruction in eight. Six patients died of either end-stage disease or wide dispersion of the tumor. Conclusion: The intratumoral administration of ⁹⁰Y-GMS under ultrasound guidance yielded a higher cure rate for liver malignancy with no severe side effects. The higher radiation dosage delivered by injected ⁹⁰Y to the periphery of the lesions (up to 28,215-75,720 cGy) was thought to account for the successful outcome. These results show that intratumoral radionuclide injection is feasible for treatment of malignant lesions inside the body.

Key Words: yttrium-90-glass microspheres • radionuclide therapy • liver malignancy • intratumoral delivery

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				W.-Y. Lin, S.-C. Tsai, J.-F. Hsieh, and S.-J. Wang Effects of 90Y-Microspheres on Liver Tumors: Comparison of Intratumoral Injection Method and Intra-Arterial Injection Method J. Nucl. Med., November 1, 2000; 41(11): 1892 - 1897. [Abstract] [Full Text] [PDF]